Short report: the effect of misoprostol on the anaemia of NSAID enteropathy

Aliment Pharmacol Ther. 1994 Jun;8(3):343-6. doi: 10.1111/j.1365-2036.1994.tb00298.x.


Background: Small bowel ulceration is an increasingly recognised complication of therapy with non-steroidal anti-inflammatory drugs (NSAID). The ulceration is a potent site of blood loss contributing to unexplained iron deficiency anaemia in patients with arthritis. No drug is currently available to treat NSAID small bowel ulcers.

Methods: We have retrospectively examined the effect of therapy with the prostaglandin E1 analogue misoprostol on the anaemia of patients with enteroscopically proven NSAID small bowel enteropathy.

Results: All of the patients had proven iron deficiency anaemia. Eleven patients received misoprostol and ten received no treatment. Haemoglobin in the misoprostol-treated group rose significantly from median (range) 9.1 (6.2-10.6) g/dL (95% confidence intervals 8.76, 10.13) to 10.6 (6.5-16.8) g/dL (95% confidence intervals 10.06, 11.82); P = 0.004). Those patients who did not receive misoprostol had no significant change in their haemoglobin: 9.1 (7.5-10.6) g/dL to 8.1 (5.6-14.7) g/dL (P = N.S.).

Conclusion: Misoprostol therapy was associated with an improvement in the anaemia in patients with proven NSAID enteropathy.

MeSH terms

  • Adult
  • Aged
  • Anemia, Iron-Deficiency / drug therapy*
  • Anemia, Iron-Deficiency / etiology
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Female
  • Humans
  • Intestinal Diseases / chemically induced
  • Intestinal Diseases / complications*
  • Male
  • Middle Aged
  • Misoprostol / administration & dosage*
  • Misoprostol / adverse effects
  • Retrospective Studies
  • Rheumatic Diseases / drug therapy*
  • Ulcer / chemically induced
  • Ulcer / complications


  • Anti-Inflammatory Agents, Non-Steroidal
  • Misoprostol